Manometer device



United States Patent Paul E. Rockwell 38 Belle Ave., Troy, New York12180 [2i] Appl. No. 688,852

[22] Filed Dec. 7, 1967 [45 Patented Sept. 22, 1970 [72] lnventor [54]MANOMETER DEVICE 5 Claims, 9 Drawing Figs.

[52] U.S. Cl 12812.05 [51] lnt.Cl A6lb 5/02 [50] Field of Search128/205; 128/214 [56] References Cited UNITED STATES PATENTS 3,242,9203/1966 Andersen l28/2.05 3,413,970 12/1968 Rockwell [ZS/2.05 3,435,8194/1969 Reynolds et al. l28/2.05 3,460,526 8/1969 McKirdy et al. l28/2.05915,329 3/1909 Bishop l28/2.05

1,225,395 5/1917 Beachler l28/2.05

3,033,038 5/1962 Murphy 73/388 3,124,133 3/1964 Marbach. 128/2143,336,917 8/l967 Pile 128/2 FOREIGN PATENTS 6,702,903 l0/l967Netherlands 128/205 Primary Examiner-Dalton L. Truluck Attorney-WalterF. Wessendorf, Jr.

ABSTRACT: A manometer device for use in the measurement of centralvenous pressure and peripheral venous pressure comprising a flat,longitudinal member having centimeter indicia thereon and two upstandingguides each having two holes formed therethrough. One hole of each guidemounts tubing to register centimeters of water reading with reference tothe centimeter indicia, and the other hole of each guide verticallymounts the manometer device on cord or other tubing. A hole and itsassociated guide function as a clamp for adjustable vertical mounting ofthe manometer device.

FIG..2.

JNVENTOR. PAUL E. ROCK WELL BY amp t/M;

Patented Sept. 22, 1970 3,529,592

Sheet 2 of 3 INVENTOR.

PAUL E. ROCKWELL BY Patented Se t.'22,1970 Y 7 3,529,592

Sheet 3 of5 I If l I fl l "WWII i 7 I LLY;

INVENTORL .PAUL IE.ROCKWELL FIG. 8. MEN/ MANOME'IER DEVICE Thisinvention relates to a manometer device for use in the measurement ofcentral venous pressure (hereinafter referred to as CVP) and peripheralvenous pressure.

Reusable glass manometers costing approximately $10.00 each wereutilized at one time in. peripheral venous pressure measurement. A glassmanometer was reusable after being cleaned, sterilized and repackaged.Nevertheless, there always remained the question if the glass manometerwas sterile. Taking apart the glass manometer, cleaning and sterilizingsame was a nuisance and required considerable .time. Simple arithmeticsoon established the fact that the labor cost for cleaning, sterilizingand repackaging a glass manometer approximated the cost of a disposable,sterile manometer. Therefore, a disposable manometer was developed inthe art to replace the glass manometer.

The cost of the disposable manometer with its associated piece of tubingranges from $1.50 to$3.75 when purchased in quantity. By using aseparately disposable 30-inch length of tubing with the manometer deviceof this invention, instead of the prior-art disposable manometer withits associated piece of tubing, the cost can be decreased from$l.50-$3.75 to 25 35 cents for the 30-inch length of tubing.

The object of this invention is-to solve the discussed problem of theart of the high cost of the disposable manometer with its associatedtubing by replacing same with the separate 30-inch length of tubingutilized with the manometer device of the invention.

This object and other objects of the invention should be discerned andappreciated by reference to the drawings, wherein like referencenumerals refer to similar parts throughout the several views, in which:

FIG. 1 is a view of one embodimentof the manometer device of theinvention;

FIG. 2 is a view of another embodiment of the manometer device of theinvention;

FIG. 3 is a view taken in the direction of the arrows 3-3 of FIG. 1;

FIG. 4 is a view taken in the direction of the arrows 4-4 of FIG. 2;

FIG. 5 is a view of the manometer device of FIG. I mounted on the branchtubing communicating with the drip chamber;

FIG. 6 is a blown-up, fragmentary view of FIG. Sin perspec- FIG. 7 is aview of the manometer device of FIG. I mounted on a cord attached to theextension of the intravenous pole;

FIG. 8 is a.view of the manometer device utilized with a modifiedaccessory instrument; and

FIG. 9 is a view taken in the direction of the arrows 9-9 of FIG. 8.

In'FlG. l of the application for U.S. Letters Patent of Paul E.Rockwell, M.D., for Accessory Instrument for the Measurement of CentralVenous Pressure," Ser. No. 634,310, filed Apr. 27, 1967, U.S. Pat. No.3,413,970, granted Dec. 3, l968, is shown a view of a patient disposedtoreceive a venous infusion by means of prior art facilities and thedetailed description with reference thereto describes feeding thepatient with venous infusion fluid, then filling the manometer 'withvenous infusion fluid and then leveling of the venous infusion fluid inthe manometer to render the measurement of-the patients'CVP. The set-upshown in FIG. 1 of this application for CVP measurement is similar totheset-up shown in FIG. I

of Dr. Rockwell's patent.

In FIG. I of the drawingsis shown an intravenouspole I with adouble-branch-extension 3. Branch 5 carries the hanger 7 ohm intravenousbottle 9 disposed in inverted relationship. Bottle 9 communicates withthe drip chamber II. The threeway valve 13 has branch tubing 15 and 17which communicate, respectively, with drip chamber 11 and the needle(not shown) which preparatory thereto was inserted, normally, in Y acommunicating relationship of tubing 17 with such inserted needle, acatheter (not shown) was threaded through such needle and into thepatient's superior vena cava.

Reference numeral 19 generally refers to the manometer device of thisinvention. Themanomet er device comprises a flat, vertical,'longitudinal mem'ber 2! having centimeter indicia 23 thereon.Up-standing from the lower portion and upstanding from the upper portionof longitudinal member 21 are similar respective guides 25. The twoguides 25 each have two vertical holes formed therethrough, as shown inFIG. 3.

A cord 29 is trained over branch 31 of extension 3. One end of cord 29is in the form of a closed loop that is disposed beneath upper guide 25of the manometer device 19. Weight 33 is carried on the other end ofcord 29, as shown. The intermediate portion 35 of cord 29 is disposedwithin the holes 27 on the left sides of guides 25, as viewed in FIG. 1.Weight 33 is a counterbalancing weight. Hence, if the manometer deviceis moved vertically up or down, the manometer device I9 will remain inthe vertical position to which it is disposed.

A 30-inch tubing 37 carries on one end aplastic adapter39 having anexternal diameter greater than the diameter of any of the holes 27 tothereby function as a limit stop when tubing 37 is sufficiently disposedthrough the hole27 on the right side of the upper guide 25, as viewed inFIG. 1, until plastic adapter 39 abuts the upper surface of the upperguide 25. The other end of tubing 37 is rendered in communicatingrelationship with a branch of the three-way valve 13, as shown.

Carried on the lower portion of longitudinal member 21 is a cross member41 transversely disposed therewith. Longitudinal member'Zl and its crossmember 41 approximate a T- square. The upper surface of cross member 41is aligned with the zero'mark of the centimeter indicia 23, as shown.

The conventionalprocedure to effect CVP measurement of the patient,utilizing the manometer device of the invention, is

as follows: First the physician ascertains by measurement theantereo-posterior diameter of the patients chest, half of whichmeasurement is the reference locus of the vertical centimeter distanceof the patient's superior vena cava from the skin of the patients back.If the manometer device 19 is so vertically disposed that the zero markof centimeter indicia 23 lies within the same horizontal plane passingthrough such ascertained reference locus of the patients superior venacava,

then accurate measurement can be made of the patient's CVP. Next thethree-way valve 13 is disposed in such position that communicationoftubing 37 is closed and communication of intravenous bottle 9 throughtubing 15 and 17 is opened thereby feeding the patient venous infusionfluid from intravenous bottle 9. Then the three-way valve 13 is disposedin such position that communication from intravenous bottle 9 throughtubing .17 to the patient is shut off and communication from intravenousbottle 9 through tubing 15 andtubing 37 is openedthereby filling thetubing 37 with venous infusion fluid. Then the three-way valve 13 isdisposed in such position that the only communication open is fromtubing 37 through tubing 17 to the patient; hence, the patient is beingfed venous infusion fluid from tubing 37. The fluid in tubing 37 willlevel itself shortly and the liquid line of venous infusion fluid intubing 37, by reference to the centimeter indicia 23, will-bethepatients CVP as measured in centimeters of water.

When the prior-art, disposable manometer is used in suchconventional.procedure,same is taped or clipped to one of theintravenous poles. During an operation the sterile, surgical drapes areoften raisedand taped, or otherwise secured, to intravenous poles foraccess to the patient's head for anesthesia purposes. Intravenous polesare used in this manner because of their height and convenient accessfor such drape secure ment purposes. After the initial CVP measurementthe operating table is often elevated for the surgeon's conveniencerendering CVP remeasurement inaccurate and necessitating thatsuchprior-art, disposable manometer be untaped, raised to that new verticalposition to assure accuracy of subsequent CVP remeasurement by renderingthe zero mark of the centimeter scale in the same horizontal planeoccupied by the changed superior vena cava reference locus, and retapedin such redisposed vertical position. The drapes secured on themanometers intravenous pole often interfere with this required raisingof such prior-art, disposable manometer to such required new verticalposition. However, with the manometer device of this invention thedescribed and necessary vertical redisposition to assure accuracy insubsequent CVP remeasurement can be accomplished simply, easily andquickly without the necessity of further assistance by other occupiedoperating-room personnel in contrast to the need for such furtherassistance when the prior-art, disposable manometer is used. Thedifferences in the diameters of the intravenous pole and its extensionrender clipped retension of the prior-art, disposable manometer to suchextension difficult at times. Such simplicity, ease and quickness ofvertical redisposition of the manometer device of this invention shouldbe readily discerned from the detailed description of the drawingfigures herein.

Also, compared to the prior-art, disposable manometer, the 30-inchtubing carried by the guides away from the centimeter indicia rendersreadings contrastingly and hence significantly easier.

In FIGS. 2 and 4, the manometer device shown differs structurally frommanometer device 19 shown and described with reference to FIGS. 1 and 3only in that two magnets 43, as shown, are mounted on the flat,longitudinal member 21 by means of screws 45 retentively engaged withtapped holes in magnets 43. The mating surfaces 47 of magnets 43 arecomplemental to the surface of the intravenous pole 1, as shown. The30-inch tubing 37 would be disposed on this manometer device as it wasin manometer device 19 of FIGS. 1 and 3, and the same procedure, asheretofore described, followed to effect CVP measurement of the patient.Magnets 43 function to facilitate the vertical disposition of themanometer device by movement of same up and down intravenous pole 1.

In FIGS. 5 and 6, the manometer device 19 is shown mounted on branchtubing and adjustably disposed in such vertical disposition by insertingbranch tubing 15 in the holes 27 on the left sides of guides 25, asviewed in FIG. 5. In FIG. 6, branch tubing 15 is disposed in an Sconfiguration with reference to the upper guide and its hole 27 topermit such cooperating upper guide 25 and its hole 27 to function as aclamp to adjustably retain manometer device 19 in the verticaldisposition as disposed. However, this described clamping function isnot sufficient to close branch tubing 15 to prevent flow therethrough ofvenous infusion fluid from intravenous bottle 9. It should beappreciated that adjustable vertical disposition of manometer device 19is accomplished by loosening that portion of branch tubing 15 from its Sconfiguration, disposing manometer device 19 in the preferred verticaldisposition and then redisposing the appropriate part of branch tubing15 in the S configuration in conjunction with upper guide 25 and itshole 27. to again accomplish the cooperative clamping function.

In FIG. 7, the manometer device 19 is shown mounted on a cord 49 securedto and suspended front branch 31 of extension 3. As is shown in FIG. 7,manometer device 19 mounted on cord 49 is adjustably disposed in itsvertical disposition in the same manner and with the same attendantclamping function by which the manometer device 19 was adjustablydisposed in vertical disposition on branch tubing 15 in FIGS. 5 and 6.It should be noted that a similar S configuration is effected with cord49 to accomplish the clamping function of the cooperating upper guide 25and its hole 27. It should be appreciated that cord 49 could similarlybe suspended from the ceiling of a hospital room.

In FIGS. 8 and 9, the manometer device 19 is shown utilized with amodified accessory instrument 51. The manometer device 19, of course,would be vertically disposed by any of the vertical mounting meansheretofore shown and described for mounting the manometer device 19. Themodified accessory instrument 51 is the accessory instrument shown inFIGS. 2 and 3 in Dr. Rockwell's patent, and modified by superposing infixed relationship on each flat side of vertical leg 53 the flatshoulder members 55.

As was previously described, the upper surface 57 of cross member 41 isaligned with the zero mark of the centimeter indicia 23 on the flat,longitudinal member 21. The shoulder portions 59 formed by flat shouldermembers 55 are aligned with the ten centimeters indicia on vertical leg53. Ten centimeters is the average ascertained, measured distance of anadults superior vena cava from the skin of the back. Hence, whenutilizing the accessory instrument in conjunction with CVP measurementof an adult, the terminal portion (not shown) of the accessoryinstrument 51 is disposed in continguous relationship with the skin ofthe supine patients back, the shoulder portion 59 of shoulder member 55is disposed in abutting relationship with upper surface 57 of crossmember 41 with the mutual lateral sides of longitudinal member 21 andvertical leg 53 maintained also in abutting relationship, as shown, andthen longitudinal member 21 and vertical leg 53 are grasped andvertically disposed up or down as is needed to register an indication byair bubble level 63 that horizontal leg 65 of the accessory instrument51 is level. Utilizing manometer device 19 with the modified accessoryinstrument 51 in the procedure as described affords the advantages ofquick, simple and accurate setting and resetting of the manometer zerolevel which corresponds to the zero mark of centimeter indicia 23 lyingwithin the same horizontal plane passing through the reference locus ofthe average adults superior vena cava by merely leveling horizontal leg65 with reference to air bubble level 63. Thereafter, the proceduredescribed with reference to FIG. 1 to obtain the CVP measurement, and aswould be here applicable thereto, is followed.

When utilizing the manometer device 19 for measurement of peripheralvenous pressure, the set-up shown in FIG. 1 of this application for CVPmeasurement is followed but with the exception that the needle isinserted in a peripheral vein. The procedure thereafter followed issimilar.

I claim:

1. A manometer device for use with an accessory instrument for themeasurement of a patient's central venous pressure; said manometerdevice comprising a longitudinal member, centimeter indicia, guides, across member and venous measuring tubing, said longitudinal memberhaving said centimeter indicia thereon, said longitudinal member havingupper and lower portions, said guides being upstanding from the surfacesof said upper and lower portions, said cross member being transverselydisposed on said lower portion of said longitudinal member and having anupper surface in correspondence with the zero mark of said centimeterindicia, said longitudinal member having lateral sides, said crossmember extending beyond said lateral sides of said longitudinal member,said guides having aligned holes removably receiving said venousmeasuring tubing, said venous measuring tubing registeringcentimeters-of-water readings with reference to said centimeter indiciain the utilization of said manometer device for central venous pressuremeasurement; said accessory instrument comprising an L-shaped rigid barhaving a vertical leg normal to a horizontal leg, said vertical leghaving lateral sides and a bottom, said vertical leg having indicia inthe form of transverse line markings formed therein designatingcentimeter distances as measured from said bottom of said vertical leg,said vertical leg having flat shoulder members superposed in fixedrelationship on each flat side of said vertical leg, said shouldermembers having shoulder portions, said shoulder portions being alignedwith the centimeter indicia on said vertical leg designating tencentimeters and, as such, thereby corresponding to the averageascertained, measured distance of a supine adults superior vena cavafrom the skin of his back, said horizontal leg having a top side, saidtop side of said horizontal leg having an air bubble level whose bottomplane is secured with said top side of said horizontal leg and is inparallel correspondence with said horizontal leg, said horizontal legcarrying an extensible member, said extensible member having an integralend portion of sinusoidal configuration depending therefrom, saidintegral end portion curving convexly outwardly thence concavelyinwardly to its terminal portion, said integral end portion, as arrangedand constructed with respect to said accessory instrument, being adaptedfor disposition over the supine patients arm, then between the patientsarm and body, with its said terminal portion in contiguous relationshipwith the skin of the patients back, said ten centimeters indicia on saidvertical leg, and thereby said shoulder portions, of said accessoryinstrument- -as thusly disposed with respect to a supine, adult patientand leveled with reference to its air bubble level-thereby lying withinthe same horizontal plane passing through such ascertained referencelocus of the adults superior vena cava; and said manometer device andaccessory instrument, described with reference to their arrangements andconstructions, in use having the mutual lateral sides of saidlongitudinal member of said manometer device and of said vertical leg ofsaid accessory instrument in abutting relationship and in useconcomitantly having said upper surface of said cross member of saidmanometer device and said shoulder portion of said vertical leg of saidaccessory instrument in abutting relationship, and, by appropriatemovement and disposition of said manometer device to achieve suchdescribed abutting relationships with said accessory instrument, and,upon leveling of said accessory instrument to ascertain the referencelocus of the adults superior vena cava, said zero mark of saidcentimeter indicia of said manometer device likewise lying within thesame horizontal plane passing through such ascertained reference locusof the adult patient's superior vena cava.

2. The manometer device in accordance with claim 1, wherein said venousmeasuring tubing carries on one end an adapter whose external diameteris greater than the diameters of said guide holes and functions as alimit stop with respect to said venous measuring tubing received by saidguide holes.

3. The manometer device in accordance with claim 1, wherein saidlongitudinal member has magnets mounted in fixed relationship therewithand wherein said magnets are adapted for removably mounting andvertically positioning thereby said manometer device on an intravenouspole.

4. The manometer device in accordance with claim 1, wherein is furtherprovided a cord, one end of which is in the form of a closed loop andthe other end of which carries a weight, wherein said closed loop isdisposed beneath said guide upstanding from said upper portion of saidlongitudinal member, wherein said weight functions as a counterbalance,wherein said cord is adapted for adjustably mounting said manometerdevice vertically with reference to an intravenous pole by training aportion of said cord over a branch extension of the intravenous pole andwherein said counter balancing weight functions to permit said manometerdevice to remain where disposed with reference to the intravenous pole.

5. The manometer device in accordance with claim I, wherein said alignedguide holes are adapted for adjustable vertical positioning of saidmanometer device with reference to an intravenous pole by use of a cordor tubing fixed to such intravenous pole and wherein said cord or tubingis trained through said hole in said guide upstanding from said lowerportion of said longitudinal member and is removably disposed in an Sconfiguration in conjunction with said hole in said guide upstandingfrom said upper portion of said longitudinal member to thereby removablyretain said cord or tubing thereat.

